Gout and Heart Failure: What’s the Connection?
Recently, researchers designed a post-hoc, longitudinal, and cross-sectional analyses of a prospective cohort study to test a hypothesis about gout. Their hypothesis was that gouty arthritis (gout) is a risk factor for 2 things: the incidence of heart failure and echocardiographic measures that indicate subclinical heart failure.
Results of the study were published in an article in the February 2012 edition of the journal BMJ Open. The article was called “Gout and the risk for incident heart failure and systolic dysfunction.”
For this study, the researchers used the population-based Framingham Offspring Study; data were gathered in 4-year intervals starting with 1971.
A total of 4,989 adults participated in the study. The mean age of the participants was 36 years old; 52% were women, and 48% were men. At baseline, the participants did not have clinical heart failure.
There were several outcome measures for this study. They were incident heart failure, echocardiographic measures of left ventricular systolic dysfunction, dilatation, and hypertrophy.
Researchers found that those participants with gout (n=228) had a 2 to 3 times higher incidence of clinical heart failure and echocardiographic measures of systolic dysfunction compared with the participants who did not have gout.
After using Cox regression analyses, they found that gout was linked to an adjusted hazard ratio (HR) of 1.74 (95% confidence interval [CI]: 1.03 to 2.93) for incident heart failure. They also found that the relative risk was 3.70 (95% CI: 1.68 to 8.16) for abnormally low left ventricular ejection fraction and 3.60 (95% CI: 1.80 to 7.72) for global left ventricle systolic dysfunction.
They noted that these risk relationships were consistent for all of the clinical subgroups.
Additionally, they determined that study participants with gout had overall greater mortality than those who did not have gout (adjusted HR: 1.58; 95% CI: 1.40 to 1.78). They also found that mortality was higher in the subgroup of patients who had both gout and heart failure (adjusted HR: 1.50; 95% CI: 1.30 to 1.73) compared to participants who had heart failure but did not have gout.
The research team concluded that gout is linked to an increased risk for 3 things: clinical heart failure, subclinical measures of systolic dysfunction, and mortality.